HARD CHOICES: Health officials say decision between who lives and dies not a problem — yet

HARD CHOICES: Health officials say decision between who lives and dies not a problem — yet
Princess Margaret Hospital

“If we continue beyond capacity those difficult decisions will have to be made” – Forbes

NASSAU, BAHAMAS — Health officials will have to decide between who lives and dies if the country continues to go beyond its health capacity, according to Dr Nikkiah Forbes, Director of the National HIV/AIDS and Infectious Disease Programme.

During a recent press conference, Forbes advised that officials have yet to see a patient die because they haven’t been able to support them and had pick someone else to live.

She was responding to a question regarding the recent comments by former Health Minister Dr Duane Sands, insisting that healthcare workers are currently forced to make those decisions.

“The reality of the situation is if we continue beyond capacity those difficult decisions will have to be made,” she said.

As of Saturday, there were 2,245 active cases of COVID-19 and 109 hospitalized cases.

“We are in a surge and the healthcare system is pushed beyond capacity as it relates to the ability to manage patients presenting with COVID-19 and it’s a real challenge,” Forbes continued.

“There are currently more patients than the capacity of PMH.

“There’s 73 patients (as of Friday) but the bed capacity is only 70.

“The absolute reality of the situations when healthcare is beyond capacity, we won’t be able to care for the number of patients that are presenting.”

She shared a recent experience offering care at A&E, where there was no suitable room to manage a patient who came to the facility.

Forbes said healthcare workers had to shift stable patients around in order to offer the oxygen and respiratory support that patients needed.

She said patients are currently being held in areas that were not designed for COVID-19 care.

Dr Caroline Burnett, medical chief of staff at PMH explained that all patients that present to the hospital are triaged on their symptoms and categorize from one to five depending on their severity; then sent to the necessary area for management.

While on the Guardian Radio show “The Hitback” with Nahaja Black on Thursday, Sands was asked whether healthcare workers were having to decide between who lives and dies as a result of overcrowding.

“The answer, unfortunately, and I say this with a high degree of certainty and I understand the implications of my comment, the answer is yes; that is happening now,” Sands said.

But Chief Medical Officer Dr Pearl McMillian maintained that as cases in the country continue to increase, the hospital capacity will be stretched, as well as the capacity to provide care for other conditions.

Capacity 

The Bahamas currently has a COVID-19 bed capacity of 147 beds across New Providence and Grand Bahama.

The Samaritan’s Purse’s Isolation and Treatment Unit at the Princess Margaret Hospital is set to begin operations this week.

The field hospital has a capacity for 20 COVID-19 patients and is made up of seven tents, a temporary ambulance bay, male and female patient wards, with toilet facilities, donning/doffing areas for staff personal protective equipment (PPE), staff work areas, staff bathroom facilities and medical supplies.

As of Friday, 110 beds were occupied with another four people hospitalized on Saturday.

Health officials also advised that there are 65 ventilators in-country.